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Cited by 1Fatty Acid Research and HealthAtrial Fibrillation Management and OutcomesCardiac electrophysiology and arrhythmias

Effects of Omega-3 Fatty Acid Treatment on Risk for Atrial Fibrillation: An Updated Meta-Analysis of 35 Trials including 114 592 Individuals

Open access
Abuknesha, Nada R., O’Keefe, James H, Qian, Frank, Tintle, Nathan L., Lin, Yidie, Sun, Yue, Qian, Han-Zhu, Aisen, Paul S. +31 more·2026·Circulation: Arrhythmia and Electrophysiology
DOI 10.1161/circep.125.014785PMC PMC13489779
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Abstract

BACKGROUND: Recent meta-analyses of randomized controlled trials have raised concerns that treatment with omega-3 fatty acids may increase the risk of atrial fibrillation (AF). However, these meta-analyses included at most 8 trials. The aim of this current meta-analysis was to expand the search by including other eligible omega-3 randomized controlled trials with AF incidence data, incorporating both published and unpublished data. METHODS: Eligible studies were randomized controlled trials investigating daily doses of ≥500 mg/d of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Additional inclusion criteria included ≥12 months of treatment with EPA/DHA, participants ≥50 years of age, and, where possible, the absence of known AF/atrial flutter at baseline. The primary outcome was the occurrence of new-onset AF. Our primary hypothesis was that risk for AF would simultaneously depend on both omega-3 dose (above or below 1500 mg/d) and background cardiovascular disease risk status, and that their combined impact on AF risk would be synergistic. RESULTS: A total of 35 randomized controlled trials (37 data sets; n=114 592) were included in this meta-analysis. Only studies including patients at high-risk for cardiovascular disease who were treated with high-doses of EPA/DHA (>1500 mg/d) showed a statistically significant increase in AF risk with a pooled odds ratio (OR) of 1.43 (95% CI, 1.14–1.79) and an absolute risk difference of 0.8% (0.40%–1.1%). None of the other 3 groups showed statistically significant levels of AF risk (odds ratios, 1.07 [high risk–low dose], 1.06 [low risk–low dose], and 1.03 [low risk–high dose]). CONCLUSIONS: This meta-analysis suggests that high-dose EPA/DHA treatment is associated with an increased risk of AF in patients at high cardiovascular disease risk, whereas low-dose EPA/DHA does not appear to increase AF risk, even in high-risk populations. Further prospective studies are needed to evaluate any potential increased risk of higher doses balanced against potential benefits.

AI snapshot

Written from the paper’s full text.

TL;DR

In an updated meta-analysis of 35 RCTs (37 datasets; n=114,592), high-dose EPA/DHA (>1500 mg/day) in high-CVD-risk patients was associated with increased new-onset AF (pooled OR 1.43; absolute risk difference 0.8%). Other dose/risk strata were not statistically significant, and low-dose omega-3 did not appear to increase AF risk.

Key findings

  • The high-risk/high-dose stratum (12 studies; 25,603 patients; mean 2693 mg/day) showed a statistically significant increase in AF risk: pooled OR 1.43 (95% CI, 1.14–1.79) and absolute risk difference 0.8% (0.40–1.1%).
  • The other three strata were not statistically significant: high-risk/low-dose OR 1.07, low-risk/low-dose OR 1.06, and low-risk/high-dose OR 1.03; across all studies, AF risk was significantly increased by 14%.
  • Post hoc comparisons using high-risk/high-dose as reference showed lower AF risk for high-risk/low-dose (OR 0.73; 95% CI, 0.60–0.88; p=0.0012) and low-risk/low-dose (OR 0.72; 95% CI, 0.59–0.88; p=0.0015); low-risk/high-dose was OR 0.71 (95% CI, 0.30–1.64; p=0.49).
  • Sensitivity analysis using risk difference found only the high-risk/high-dose group had significantly increased risk (RD=0.8%; 95% CI, 0.40–1.1; p<0.0001); sensitivity restricted to confirmed absence of baseline AF showed similar ORs (HR-HD 1.46 vs 1.43; HR-LD 1.07 vs 1.07; LR-LD 1.06 vs 1.06).

Methods

  • Systematic review and meta-analysis registered at PROSPERO (CRD420251233813) and reported per PRISMA 2020; searches covered PubMed, ClinicalTrials.gov, ISRCTN, CDEK, medRxiv, and other sources through November 2025, with investigator outreach for unpublished AF data.
  • Eligible studies were parallel-group RCTs of EPA/DHA ≥500 mg/day, treatment ≥12 months, participants aged ≥50 years, excluding known baseline AF where possible; primary outcome was new-onset AF/flutter. Included 35 RCTs/37 datasets (n=114,592; mean age 66 years; 61% men; doses 600–4000 mg/day; duration 12–88.8 months).
  • Trials were stratified by background CVD risk (high/low) and omega-3 dose (≤1500 vs >1500 mg/day); cohort-specific unadjusted ORs used Firth’s correction and were pooled by inverse-variance weighted random-effects meta-analysis (REML), with sensitivity analyses for risk difference and confirmed baseline AF absence.

Limitations

  • Stated: the authors could not ensure all relevant studies were included, and for many RCTs the status of AF outcomes was unclear because principal investigators no longer had access to original raw datasets and could not confirm whether AF events were systematically collected or adjudicated.
  • Stated/evident: endpoint definitions were not standardized across studies, and AF ascertainment varied (central adjudication, ECG, electronic medical records, insurance claims, and/or patient-reported adverse events); unpublished data were available only with permission and are not publicly available.
  • Evident: the low-risk/high-dose finding was based on relatively few events and the authors call it tentative; only two studies, both in the high-risk/high-dose group, found a statistically significant increase in AF risk.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1161/circep.125.014785

Cites

135 of 143 references verified8 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

34 of 58 cited sources checked · 16 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Prior meta-analyses of omega-3 and AF included at most eight trials.

    “However, these meta-analyses included at most eight trials.”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [1] Gencer B, Djousse L, Al-Ramady OT, Cook NR, Manson JE, Albert CM. Effect of long-term marine omega-3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: a systematic review and meta-analysis. Circulation. 2021; 144: 1981– 1990. doi: 10.1161/CIRCULATIONAHA.121.055654. 34612056 PMC9109217 source

      The Results section says five trials in this paper had already appeared in a previous meta-analysis. That supports the trial-count claim for one prior meta-analysis, but our copy does not establish that all the prior meta-analyses referred to in the citing sentence included at most eight trials. No page number is available in our copy. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
    • cites [2] Bae JH, Lim H, Lim S. The potential cardiometabolic effects of long-chain ω-3 polyunsaturated fatty acids: recent updates and controversies. Adv Nutr. 2023; 14: 612– 628. doi: 10.1016/j.advnut.2023.03.014. 37031750 PMC10334139 source

      The ‘New-onset atrial fibrillation’ section discusses an earlier study and the paper’s own meta-analysis, but gives no trial count for prior meta-analyses. Searches for ‘eight trials,’ ‘8 trials,’ and prior meta-analysis trial counts found no passage establishing the claimed maximum of eight. (LLM, conf=0.72)

      Experimental — accuracy not yet measured
    • cites [3] Jia X, Gao F, Pickett JK, Al Rifai M, Birnbaum Y, Nambi V, Virani SS, Ballantyne CM. Association between omega-3 fatty acid treatment and atrial fibrillation in cardiovascular outcome trials: a systematic review and meta-analysis. Cardiovasc Drugs Ther. 2021; 35: 793– 800. doi: 10.1007/s10557-021-07204-z. 34057665 source
  • Premisecitation

    Omega-3 treatment reduces resting heart rate through increasing vagal tone even at relatively low doses of about 500 mg/d.

    “Omega-3 treatment has been shown to reduce resting heart rate121 through increasing vagal tone even at relatively low doses of about 500 mg/d121, 122.”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [121] Mozaffarian D, Geelen A, Brouwer IA, Geleijnse JM, Zock PL, Katan MB. Effect of fish oil on heart rate in humans: a meta-analysis of randomized controlled trials. Circulation. 2005; 112(13): 1945– 1952. doi: 10.1161/CIRCULATIONAHA.105.556886. 16172267 source

      The supplied passage is a bibliographic entry identifying the paper as a meta-analysis of fish oil and heart rate; it gives no findings. Searches for resting-heart-rate reduction, vagal tone, and a dose of about 500 mg/d found no supporting passage in our copy. (LLM, conf=0.69)

      Experimental — accuracy not yet measured
    • cites [122] Christifano DN, Chollet-Hinton L, Mathis NB, Gajewski BJ, Carlson SE, Colombo J, DHA supplementation during pregnancy enhances maternal vagally mediated cardiac autonomic control in humans. J Nutr. 2023; 152(12): 2708– 2715. doi: 10.1093/jn/nxac178. 35953431 PMC9839999 source
  • Premisecitation

    In REDUCE-IT, the 1.0% absolute increase in AF hospitalization with 4 g/day EPA was offset by a 4.8% absolute reduction in MACE.

    “For example, in REDUCE-IT, the 1.0% absolute increase in AF hospitalization with 4 g/day EPA was offset by a 4.8% absolute reduction in MACE69”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [69] Olshansky B, Bhatt DL, Miller M, Steg PG, Brinton EA, Jacobson TA, Cardiovascular benefits of icosapent ethyl in patients with and without atrial fibrillation in REDUCE-IT. J Am Heart Assoc. 2023; 12(5): e026756. doi: 10.1161/JAHA.121.026756. 36802845 PMC10111466 source
  • Premisereasoning

    Across several major RCTs (REDUCE-IT, RESPECT-EPA, GISSI-HF, ASCEND), the magnitude of CV benefit equaled or exceeded the observed increase in AF risk.

    “Across several major RCTs, such as REDUCE-IT69, 125, RESPECT-EPA76, GISSI-HF77 and ASCEND79, 105; the magnitude of CV benefit equaled or exceeded the observed increase in AF risk.”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [69] Olshansky B, Bhatt DL, Miller M, Steg PG, Brinton EA, Jacobson TA, Cardiovascular benefits of icosapent ethyl in patients with and without atrial fibrillation in REDUCE-IT. J Am Heart Assoc. 2023; 12(5): e026756. doi: 10.1161/JAHA.121.026756. 36802845 PMC10111466 source
    • cites [76] Miyauchi K, Iwata H, Nishizaki Y, Inoue T, Hirayama A, Kimura K, Randomized trial for evaluation in secondary prevention efficacy of combination therapy–statin and eicosapentaenoic acid (RESPECT-EPA). Circulation. 2024; 150(6): 425– 434. doi: 10.1161/CIRCULATIONAHA.123.065520. 38873793 source
    • cites [79] Bowman L, Mafham M, Wallendszus K, Stevens W, Buck G, Barton J, Effects of n-3 fatty acid supplements in diabetes mellitus. N Engl J Med. 2018; 379(16): 1540– 1550. doi: 10.1056/NEJMoa1804989. 30146932 source

      The paper identifies ASCEND as a randomized trial and reports fewer vascular deaths in an exploratory analysis (Primary and Secondary Outcomes; page not provided). But it found no significant reduction in serious vascular events, and our copy does not report an increase in atrial fibrillation risk or compare that risk with cardiovascular benefit. The claimed benefit–risk comparison for ASCEND is therefore unsupported. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Interpretationcitation

    The presumed protective effect of omega-3 against stroke may relate to the mild anti-thrombotic effects of EPA and DHA.

    “This presumed protective effect against stroke may relate to the mild anti-thrombotic effects of EPA and DHA127, 128.”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [127] Javaid M, Kadhim K, Bawamia B, Cartlidge T, Farag M, Alkhalil M. Bleeding risk in patients receiving omega-3 polyunsaturated fatty acids: a systematic review and meta-analysis of randomized clinical trials. J Am Heart Assoc. 2024; 13(10): e032390. doi: 10.1161/JAHA.123.032390. 38742535 PMC11179820 source

      The paper proposes antithrombotic and antiplatelet effects of omega-3 PUFAs as possible explanations for cardiovascular benefit (introductory text and Discussion; page unavailable). It does not specifically connect EPA and DHA’s effects to protection against stroke; its stroke analysis concerns hemorrhagic-stroke bleeding risk. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [128] Wachira JK, Larson MK, Harris WS. n-3 Fatty acids affect haemostasis but do not increase the risk of bleeding: clinical observations and mechanistic insights. Br J Nutr. 2014; 111(9): 1652– 1662. doi: 10.1017/S0007114513004269. 24472372 source
  • Classified as probably not a substantial claim. 22
  • May combine two claims. 28

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Gencer et al. reviewed seven RCTs focused on cardiovascular outcomes and found that risk for AF was increased by 25% with omega-3 treatment.

    “Gencer et al. reviewed seven RCTs focused on cardiovascular (CV) outcomes and found that risk for AF was increased by 25% with omega-3 treatment1.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [1] Gencer B, Djousse L, Al-Ramady OT, Cook NR, Manson JE, Albert CM. Effect of long-term marine omega-3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: a systematic review and meta-analysis. Circulation. 2021; 144: 1981– 1990. doi: 10.1161/CIRCULATIONAHA.121.055654. 34612056 PMC9109217 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The conduct and reporting of this systematic review and meta-analysis adhered to the PRISMA 2020 guidelines.

    “The conduct and reporting of this systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines7.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [7] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372: n71. doi: 10.1136/bmj.n71. 33782057 PMC8005924 source

      The Scope of the guideline section identifies PRISMA 2020 as guidance for reporting systematic reviews, including those with meta-analysis. It explicitly says PRISMA 2020 is not intended to guide review conduct. The source also cannot establish whether the citing authors actually adhered to its reporting recommendations. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Methodological concerns have been raised regarding prior interventional analyses, including inconsistent reporting of AF outcomes, potential informative censoring due to longer survival in omega-3 treated groups compared to placebo groups, and/or discrepancies in AF case ascertainment.

    “methodological concerns have been raised regarding prior interventional analyses including inconsistent reporting of AF outcomes, potential informative censoring due to longer survival in omega-3 treated groups compared to placebo groups5, and/or discrepancies in AF case ascertainment6.”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [5] Samuel M, Nattel S. Fish oil supplements may increase the risk for atrial fibrillation: what does this mean? Circulation. 2021; 144: 1991– 1994. doi: 10.1161/CIRCULATIONAHA.121.057464. 34928703 source
    • cites [6] Parish S, Mafham M, Offer A, Barton J, Wallendszus K, Stevens W, Effects of omega-3 fatty acid supplements on arrhythmias. Circulation. 2020; 141: 331– 333. doi: 10.1161/CIRCULATIONAHA.119.044165. 31986094 source

      The results section (pp. 331–333; exact page unavailable in our copy) reports fewer cardiac deaths in the omega-3 group than in the placebo group (1.7% versus 2.2%). That supports a mortality difference, but the paper does not establish longer overall survival or raise informative censoring as a concern for AF analyses. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Bae et al. reported similar associations between omega-3 treatment and increased AF risk.

    “Bae et al. reported similar associations2”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [2] Bae JH, Lim H, Lim S. The potential cardiometabolic effects of long-chain ω-3 polyunsaturated fatty acids: recent updates and controversies. Adv Nutr. 2023; 14: 612– 628. doi: 10.1016/j.advnut.2023.03.014. 37031750 PMC10334139 source

  • Classified as probably not a substantial claim.

    Premisecitation

    A 2023 biomarker-based meta-analysis of 17 prospective cohorts found that higher circulating levels of marine omega-3 FAs were inversely associated with incident AF.

    “a 2023 biomarker-based meta-analysis of 17 prospective cohorts found that higher circulating levels of marine omega-3 FAs were inversely associated with incident AF”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [4] Qian F, Tintle N, Jensen PN, Lemaitre RN, Imamura F, Feldreich TR, Omega-3 fatty acid biomarkers and incident atrial fibrillation. J Am Coll Cardiol. 2023; 82: 336– 349. doi: 10.1016/j.jacc.2023.05.024. 37468189 source

      The Abstract reports a pooled analysis of 17 prospective cohorts and inverse associations of higher DPA, DHA, and EPA+DHA biomarker levels with incident AF. But EPA alone was not associated with incident AF, so the claim overgeneralizes the inverse association to marine omega-3 fatty acids as a whole. The study also measured biomarkers in blood or adipose tissue, not only circulating levels. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim.

    Premisereasoning

    An omega-3 dose threshold of 1500 mg/day distinguishes intakes achievable through diet or dietary supplements from those requiring pharmacological formulations.

    “Omega-3 dose was categorized as ≤1500 mg/day or >1500 mg/day to distinguish intakes achievable through diet or dietary supplements from those requiring pharmacological formulations.”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites [17] Harris WS, von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med. 2004; 39: 212– 220. doi: 10.1016/j.ypmed.2004.02.030. 15208005 source
    • cites [18] Walker RE, Jackson KH, Tintle NL, Shearer GC, Bernasconi A, Masson S, Predicting the effects of supplemental EPA and DHA on the Omega-3 Index. Am J Clin Nutr. 2019; 110: 1034– 1040. doi: 10.1093/ajcn/nqz161. 31396625 source
    • cites [4] Qian F, Tintle N, Jensen PN, Lemaitre RN, Imamura F, Feldreich TR, Omega-3 fatty acid biomarkers and incident atrial fibrillation. J Am Coll Cardiol. 2023; 82: 336– 349. doi: 10.1016/j.jacc.2023.05.024. 37468189 source

      The Discussion (page unavailable) contrasts habitual dietary intake, averaging 0.43 g/day in the countries studied, with more than 1.8 g/day added in high-dose trials. It does not establish a 1,500 mg/day cutoff or say that intakes above it require pharmacological formulations. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Upper quintile levels of the omega-3 index have been associated with the lowest risk of AF, stroke, and all-cause mortality in large long-term epidemiological studies.

    “which have been associated with the lowest risk of AF4, 19, stroke20, and all-cause mortality21 in large long-term epidemiological studies.”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [4] Qian F, Tintle N, Jensen PN, Lemaitre RN, Imamura F, Feldreich TR, Omega-3 fatty acid biomarkers and incident atrial fibrillation. J Am Coll Cardiol. 2023; 82: 336– 349. doi: 10.1016/j.jacc.2023.05.024. 37468189 source

      The Central Illustration reports lower AF risk in the highest versus lowest quintile of blood or tissue omega-3 levels in 17 cohorts followed for a median of 13.3 years. The ‘Association with incident atrial fibrillation’ section also reports lower AF incidence with higher EPA+DHA. The paper does not establish that the highest quintile of the specifically named omega-3 index had the lowest risk among all quintiles. Stroke and all-cause mortality have separate citations in the citing sentence and are not assessed here. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
    • cites [19] O'Keefe EL, O'Keefe JH, Tintle NL, Franco WG, Westra J, Harris WS. Associations between plasma omega-3 and fish oil use with risk of atrial fibrillation in the UK Biobank. J Am Heart Assoc. 2025; 14: e043031. 41368832 PMC12826911 source
    • cites [20] O'Keefe JH, Tintle NL, Harris WS, O'Keefe EL, Sala-Vila A, Attia J, Omega-3 blood levels and stroke risk: a pooled and harmonized analysis of 183 291 participants from 29 prospective studies. Stroke. 2024; 55: 50– 58. doi: 10.1161/STROKEAHA.123.044281. 38134264 PMC10840378 source

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Recent meta-analyses of randomized controlled trials have raised concerns that omega-3 fatty acid supplementation may increase the risk of incident atrial fibrillation, potentially in a dose-dependent manner.

    “Recent meta-analyses of randomized controlled trials (RCTs) have raised concerns that omega-3 fatty acid (FA) supplementation may increase the risk of incident atrial fibrillation (AF), potentially in a dose-dependent manner.”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [1] Gencer B, Djousse L, Al-Ramady OT, Cook NR, Manson JE, Albert CM. Effect of long-term marine omega-3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: a systematic review and meta-analysis. Circulation. 2021; 144: 1981– 1990. doi: 10.1161/CIRCULATIONAHA.121.055654. 34612056 PMC9109217 source
    • cites [2] Bae JH, Lim H, Lim S. The potential cardiometabolic effects of long-chain ω-3 polyunsaturated fatty acids: recent updates and controversies. Adv Nutr. 2023; 14: 612– 628. doi: 10.1016/j.advnut.2023.03.014. 37031750 PMC10334139 source
    • cites [3] Jia X, Gao F, Pickett JK, Al Rifai M, Birnbaum Y, Nambi V, Virani SS, Ballantyne CM. Association between omega-3 fatty acid treatment and atrial fibrillation in cardiovascular outcome trials: a systematic review and meta-analysis. Cardiovasc Drugs Ther. 2021; 35: 793– 800. doi: 10.1007/s10557-021-07204-z. 34057665 source

  • Classified as probably not a substantial claim.

    Interpretationcitation

    Higher circulating levels of marine omega-3 FAs suggest a potential protective impact of low to intermediate doses known to produce such blood levels.

    “suggesting a potential protective impact of low to intermediate doses known to produce such blood levels4.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [4] Qian F, Tintle N, Jensen PN, Lemaitre RN, Imamura F, Feldreich TR, Omega-3 fatty acid biomarkers and incident atrial fibrillation. J Am Coll Cardiol. 2023; 82: 336– 349. doi: 10.1016/j.jacc.2023.05.024. 37468189 source

      The Central Illustration reports a 6%–13% lower atrial-fibrillation risk in the highest versus lowest quintile of blood or tissue omega-3 levels, and the Discussion says those levels largely reflect habitual dietary intake. The paper does not establish that low-to-intermediate doses produce those specific blood levels or that giving such doses has a protective effect; its finding is observational. (LLM, conf=0.83)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Observational studies consistently show that an O3I of ≥8% is ideal for reducing risk of major adverse cardiovascular events, stroke, and all-cause mortality.

    “Observational studies consistently show that an O3I of ≥8% is ideal for reducing risk of major adverse cardiovascular events116 (MACE), stroke20 and all-cause mortality117.”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [116] Harris WS, Del Gobbo L, Tintle NL. The Omega-3 Index and relative risk for coronary heart disease mortality: estimation from 10 cohort studies. Atherosclerosis. 2017; 262: 51– 54. doi: 10.1016/j.atherosclerosis.2017.05.007. 28511049 source
    • cites [20] O'Keefe JH, Tintle NL, Harris WS, O'Keefe EL, Sala-Vila A, Attia J, Omega-3 blood levels and stroke risk: a pooled and harmonized analysis of 183 291 participants from 29 prospective studies. Stroke. 2024; 55: 50– 58. doi: 10.1161/STROKEAHA.123.044281. 38134264 PMC10840378 source

      The Results report lower total and ischemic stroke incidence at higher omega-3 levels, and the Discussion (p. 56) says the highest omega-3-index quintile had a median of about 8%, suggesting that ≥8% could be a cardioprotective goal. That supports the stroke-related association, but does not establish ≥8% as an ideal threshold for reducing stroke risk; the paper also found no association with hemorrhagic stroke. The citations attached to MACE and all-cause mortality are separate from this source's stroke citation. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [117] Harris WS, Tintle NL, Imamura F, Qian F, Korat AVA, Marklund M, Blood n-3 fatty acid levels and total and cause-specific mortality from 17 prospective studies. Nat Commun. 2021; 12(1): 2329. doi: 10.1038/s41467-021-22370-2. 33888689 PMC8062567 source

      Citation 117 is attached to the all-cause mortality portion of the sentence. The Results (Total mortality; page not supplied) associate higher EPA + DHA levels with lower all-cause mortality, but the Methods (Statistical analysis and pooling; page not supplied) say the analysis used cohort-specific quintiles rather than an absolute percentage. The paper therefore does not establish an O3I of ≥8% as an ideal threshold or show that reaching it reduces mortality. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Higher levels of omega-3 biomarkers are associated with lower risk for ASCVD, Alzheimer's disease, total dementia, heart failure, diabetes, suicidal ideation/self-harm, poor lung function, colorectal cancer, several other malignancies, atopic dermatitis, hospitalization for sepsis, liver cirrhosis, chronic kidney disease, frailty, and hip fractures.

    “Other biomarker-based studies have found higher levels of omega-3s to be associated with lower risk for ASCVD116, Alzheimer’s disease130 and total dementia130, heart failure131, diabetes132, suicidal ideation/self-harm133, poor lung function134, colorectal cancer135 and several other malignancies136, atopic dermatitis137, hospitalization for sepsis138, liver cirrhosis139, chronic kidney disease140”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [116] Harris WS, Del Gobbo L, Tintle NL. The Omega-3 Index and relative risk for coronary heart disease mortality: estimation from 10 cohort studies. Atherosclerosis. 2017; 262: 51– 54. doi: 10.1016/j.atherosclerosis.2017.05.007. 28511049 source
    • cites [130] Sala-Vila A, Satizabal CL, Tintle N, Melo van Lent D, Vasan RS, Beiser AS, Red blood cell DHA is inversely associated with risk of incident Alzheimer's disease and all-cause dementia: Framingham Offspring Study. Nutrients. 2022; 14(12): 2408. doi: 10.3390/nu14122408. 35745137 PMC9228504 source
    • cites [131] Jawad MA, O'Keefe JH, Tintle N, O'Keefe EL, Franco WG, Djoussé L, Association of plasma omega-3 levels with incident heart failure and related mortalities. Mayo Clin Proc. 2024; 99(12): 1895– 1904. doi: 10.1016/j.mayocp.2024.08.007. 39631987 PMC11665103 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The mean intake of DHA+EPA in the United States is associated with a mean DHA+EPA level in red blood cells (O3I) of approximately 5.5%.

    “This is associated with a mean DHA+EPA level in red blood cells [i.e., the O3I17, 18] of approximately 5.5 % in the US115.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [115] Schuchardt JP, Cerrato M, Ceseri M, DeFina LF, Delgado GE, Gellert S, Red blood cell fatty acid patterns from 7 countries: focus on the Omega-3 Index. Prostaglandins Leukot Essent Fatty Acids. 2022; 179: 102418. doi: 10.1016/j.plefa.2022.102418. 35366625 PMC10440636 source

  • May combine two claims.

    Premisecitation

    In the REDUCE-IT trial, high-dose EPA (4,000 mg/d) reduced relative risk of stroke by 28% despite increasing relative risk of AF by 35%.

    “Similarly, in the REDUCE-IT trial69, 125, which was comprised of high-CVD risk patients, high-dose EPA (4,000 mg/d) reduced relative risk of stroke by 28% despite increasing relative risk of AF by 35%126.”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites [69] Olshansky B, Bhatt DL, Miller M, Steg PG, Brinton EA, Jacobson TA, Cardiovascular benefits of icosapent ethyl in patients with and without atrial fibrillation in REDUCE-IT. J Am Heart Assoc. 2023; 12(5): e026756. doi: 10.1161/JAHA.121.026756. 36802845 PMC10111466 source

      The introductory passage (page unavailable) reports that REDUCE-IT tested icosapent ethyl at 4 g/day in patients with cardiovascular risk and reduced stroke by 28%. The Results (page unavailable) report more AF hospitalizations with treatment (3.1% versus 2.1%), but do not establish a 35% increase in relative risk of AF overall; the reported HR of 1.33 applies only to patients without prior AF, and the paper notes that AF events not requiring hospitalization could not be assessed. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
    • cites [125] Bhatt DL, Steg PG, Miller M, Brinton EA, Jacobson TA, Ketchum SB, Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med. 2019; 380(1): 11– 22. doi: 10.1056/NEJMoa1812792. 30415628 source
    • cites [126] Ballantyne CM, Jia X. Omega-3 fatty acids and risk for atrial fibrillation: big fish or small fry? J Am Coll Cardiol. 2023; 82(4): 350– 352. doi: 10.1016/j.jacc.2023.05.026. 37468190 source

  • May combine two claims.

    Premisecitation

    Higher omega-3 intake and blood levels are associated with lower risk of stroke.

    “Considering that stroke is the major complication of AF, it is paradoxical that higher omega-3 intake and blood levels have been repeatedly associated with a lower risk of stroke.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [20] O'Keefe JH, Tintle NL, Harris WS, O'Keefe EL, Sala-Vila A, Attia J, Omega-3 blood levels and stroke risk: a pooled and harmonized analysis of 183 291 participants from 29 prospective studies. Stroke. 2024; 55: 50– 58. doi: 10.1161/STROKEAHA.123.044281. 38134264 PMC10840378 source

  • May combine two claims.

    Premisecitation

    In a comprehensive meta-analysis of more than 180,000 subjects, patients in the top quintile of marine omega-3 blood levels had an 18% lower risk of ischemic stroke and no effect on hemorrhagic stroke compared to patients in the lowest quintile.

    “Specifically, a comprehensive meta-analysis (n > 180,000 subjects) found patients in the top quintile of marine omega-3 blood levels had an 18% lower risk of ischemic stroke, and no effect on hemorrhagic stroke compared to patients in the lowest quintile of omega-320.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [20] O'Keefe JH, Tintle NL, Harris WS, O'Keefe EL, Sala-Vila A, Attia J, Omega-3 blood levels and stroke risk: a pooled and harmonized analysis of 183 291 participants from 29 prospective studies. Stroke. 2024; 55: 50– 58. doi: 10.1161/STROKEAHA.123.044281. 38134264 PMC10840378 source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    In Japan, where average omega-3 intake approximates 1000 mg/d, age-adjusted AF incidence is substantially lower than in the US.

    “In Japan, where average omega-3 intake approximates this level118, age-adjusted AF incidence is substantially lower than in the US119, 120.”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites [118] Iso H, Kobayashi M, Ishihara J, Sasaki S, Okada K, Kita Y, Intake of fish and n-3 fatty acids and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based (JPHC) Study Cohort I. Circulation. 2006; 113(2): 195– 202. doi: 10.1161/CIRCULATIONAHA.105.581355. 16401768 source
    • cites [119] Oltman CG, Kim TP, Lee JWY, Lupu JD, Zhu R, Moussa ID. Prevalence, management, and comorbidities of adults with atrial fibrillation in the United States, 2019 to 2023. JACC Adv. 2024; 3(11): 101330. doi: 10.1016/j.jacadv.2024.101330. 39741649 PMC11686049 source

      The Results (Prevalence of atrial fibrillation) and Discussion report AF prevalence in the United States, not age-adjusted AF incidence in Japan or a Japan–US comparison. Searches for Japan, age-adjusted incidence, and omega-3 intake found no passage addressing the attributed comparison. The omega-3 intake clause has a separate citation in the citing sentence. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
    • cites [120] Inoue H, Fujiki A, Origasa H, Ogawa S, Okumura K, Kubota I, Prevalence of atrial fibrillation in the general population of Japan: an analysis based on periodic health examination. Int J Cardiol. 2009; 137(2): 102– 107. doi: 10.1016/j.ijcard.2008.06.029. 18691774 source

      The Major findings and Conclusions sections report that AF prevalence in Japan was about two-thirds that in the USA. The paper measures prevalence, not incidence, and does not report an age-adjusted incidence comparison. The omega-3 intake statement has a separate citation (118) and is not attributed to this source. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    In all four strata, residual heterogeneity estimates were less than 16% and not statistically significant (all four p>0.41).

    “In all four strata, residual heterogeneity estimates were less than 16% and not statistically significant (all four p>0.41).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The LR-HD group showed the largest reduction in AF risk compared to the HR-HD group (OR = 0.71, 95% CI: 0.30-1.64), although this was not statistically significant (p = 0.49).

    “the LR-HD group showed the largest reduction in AF risk (OR = 0.71, 95% CI: 0.30–1.64) as compared to the HR-HD group, although this was not statistically significant (p = 0.49).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The meta-analysis included 20 RCTs with published AF data and 15 with unpublished AF data.

    “This included 20 RCTs with published AF data68–87 and 15 with unpublished AF data88–102”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    High doses of omega-3 fatty acids administered to patients at high CVD risk were associated with a ~40-45% increase in AF risk, although the absolute risk increase is modest (0.8%).

    “In contrast, high doses of omega-3 fatty acids (typically from pharmacological products) administered to patients at high CVD risk, were associated with a ~40–45% increase in AF risk, although the absolute risk increase is modest (0.8%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    High-dose omega-3 can increase AF risk, especially in high-risk individuals.

    “but high-doses can increase AF, especially in high-risk individuals123”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [123] O'Keefe JH, Abuissa H, Sastre A, Steinhaus DM, Harris WS. Effects of omega-3 fatty acids on resting heart rate, heart rate recovery after exercise, and heart rate variability in men with healed myocardial infarctions and depressed ejection fractions. Am J Cardiol. 2006; 97(8): 1127– 1130. doi: 10.1016/j.amjcard.2005.11.026. 16616012 source

  • May combine two claims.

    Findingown data

    In the sensitivity analysis restricted to studies with confirmed absence of prevalent AF at baseline, the LR-HD OR differed numerically (0.68 vs. 1.03), but confidence intervals were wide and neither estimate was statistically significant.

    “Although the LR-HD OR differed numerically (0.68 vs. 1.03), confidence intervals were wide and neither estimate was statistically significant.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Trials with unresolved AF outcome status after investigator contact were excluded from the meta-analysis.

    “Trials with unresolved AF outcome status after investigator contact were excluded from the meta-analysis (Table S2).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    One reviewer extracted all relevant data, which were independently verified by a second reviewer.

    “One reviewer (NA) extracted all relevant data, which were independently verified by a second reviewer (WH).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    There is significant opportunity to re-examine the omega-3/AF issue using a broader evidence base by including supplementation studies where AF was not a prespecified outcome but would have been recorded as an adverse event had it developed.

    “thus there is significant opportunity to re-examine the omega-3/AF issue using a broader evidence base by including supplementation studies where AF was not a prespecified outcome but would have been recorded as an adverse event had it developed.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Definitions of endpoints were not standardized across studies.

    “Definitions of endpoints were not standardized across studies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The protocol for this study is registered at PROSPERO (CRD420251233813).

    “The protocol for this study is registered at the International Prospective Register of Systematic Reviews (PROSPERO, CRD420251233813).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Trial quality was assessed using the modified Jadad scale (0-8), with scores ≥5 indicating high quality.

    “Trial quality was assessed using the modified Jadad scale (0–8), with scores ≥5 indicating high quality.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    For studies that did not prespecify AF and did not report AF-related events, zero events were not assumed unless outcome ascertainment procedures and investigator confirmation justified this classification.

    “For studies that did not prespecify AF and did not report AF-related events, zero events were not assumed unless outcome ascertainment procedures and investigator confirmation justified this classification.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    We ensured that trials reporting no AF events contributed to the pooled evidence base.

    “We further ensured that trials reporting no AF events contributed to the pooled evidence base.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Jia et al. found lower risk for AF among the five low dose omega-3 FA studies compared with risk in three higher risk studies.

    “Jia et al. found lower risk for AF among the five low dose omega-3 FA studies compared with risk in three higher risk studies3.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Jia X, Gao F, Pickett JK, Al Rifai M, Birnbaum Y, Nambi V, Virani SS, Ballantyne CM. Association between omega-3 fatty acid treatment and atrial fibrillation in cardiovascular outcome trials: a systematic review and meta-analysis. Cardiovasc Drugs Ther. 2021; 35: 793– 800. doi: 10.1007/s10557-021-07204-z. 34057665 source

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Studies were included only when AF outcome status could be confirmed or when monitoring procedures justified the absence of reported events.

    “Studies were included only when AF outcome status could be confirmed or when monitoring procedures justified the absence of reported events.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    To minimize reporting bias, we proactively contacted principal investigators of eligible trials to determine whether AF outcomes had been collected or could be verified.

    “To minimize reporting bias, we proactively contacted principal investigators of eligible trials to determine whether AF outcomes had been collected or could be verified.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    On average, North American adults eat <1 serving per week of fish/seafood; thus, the mean intake of DHA+EPA in the United States is only ~100 mg/d.

    “on average, North American adults eat <1 serving per week of fish/seafood; thus, the mean intake of DHA+EPA in the United States (US) is only ~100 mg/d114.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [114] Gebauer SK, Psota TL, Harris WS, Kris-Etherton PM. n-3 fatty acid dietary recommendations and food sources to achieve essentiality and cardiovascular benefits. Am J Clin Nutr. 2006; 83(6 Suppl): 1526S– 1535S. doi: 10.1093/ajcn/83.6.1526S. 16841863 source

  • May combine two claims.

    Interpretationreasoning

    Omega-3 supplementation providing <1500 mg of EPA+DHA per day (and possibly up to 2400 mg) can be used safely with respect to AF risk, whereas doses exceeding 3000 mg/day in high-risk CVD populations may warrant caution.

    “These findings suggest that omega-3 supplementation providing <1500 mg of EPA+DHA per day (and possibly up to 2400 mg) can be used safely with respect to AF risk, whereas doses exceeding 3000 mg/day in high-risk CVD populations may warrant caution.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Meta-analyses of prospective cohort studies focusing on omega-3 blood levels as the exposure have reported lower risk for mortality from all causes and from CVD, cancer and remaining other causes.

    “Meta-analyses of prospective cohort studies focusing on omega-3 blood levels as the exposure have reported lower risk for mortality from all causes and from CVD, cancer and remaining other causes21.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] O'Keefe EL, O'Keefe JH, Tintle NL, Westra J, Albuisson L, Harris WS. Circulating docosahexaenoic acid and risk of all-cause and cause-specific mortality. Mayo Clin Proc. 2024; 99: 534– 541. doi: 10.1016/j.mayocp.2023.11.026. 38506781 PMC11432052 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The finding that EPA/DHA intakes at approximately 2400 mg/day are safe in the general population is consistent with the FDA's designation that EPA/DHA intakes of up to 3000 mg/d are 'generally recognized as safe'.

    “Nevertheless, this is consistent with the Food and Drug Administration’s designation of EPA/DHA intakes of up to 3000 mg/d are ‘generally recognized as safe’113.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [113] FDA. GRAS Notices for Menhaden Oil. Federal Register. 1997 [Internet]. Available at: https://www.fda.gov/ohrms/dockets/dockets/95s0316/95s-0316-rpt0299-053-Appendix-A-Tab-F-Ref-047-FDA-1997B-vol2.pdf (Accessed: 24 September 2024).

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationown data

    The consistency of the AF signal across different omega-3 formulations suggests that the observed AF signal in high-risk patients is unlikely to be attributable to a single omega-3 formulation, but rather appears to be linked to dose and background CVD risk.

    “This consistency across formulations suggests that the observed AF signal in high-risk patients is unlikely to be attributable to a single omega-3 formulation, but rather appears to be linked to dose and background CVD risk.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    The meta-analysis systematically integrated underutilized data sources, including trial registry adverse event records and unpublished datasets, reducing selective reporting bias.

    “Unlike earlier work that relied almost exclusively on published reports, we systematically integrated underutilized data sources, including trial registry adverse event records and unpublished datasets (Table S1); thereby reducing selective reporting bias.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Elevated blood omega-3 levels (achieved through diet and/or supplementation) are associated with reduced ASCVD risk and other favorable health outcomes.

    “Given that elevated blood omega-3 levels (achieved through diet and/or supplementation) are associated with reduced ASCVD risk and other favorable health outcomes, the small AF signal in HR-HD populations should be weighed against the substantial CV benefits when making treatment decisions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    These ecological considerations are at least consistent with the view that in the general population, even relatively high doses (1-1.5 g/d) do not increase risk, and indeed may decrease risk, for AF.

    “These ecological considerations are at least consistent with the view that in the general population, even relatively high doses (1–1.5 g/d) do not increase risk, and indeed may decrease risk, for AF.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Recent cost-effectiveness analyses demonstrate that the reduction in MACE more than compensates for increased AF risk, supporting an overall favorable benefit-risk balance for high-dose omega-3 therapy.

    “This interpretation aligns with recent cost-effectiveness analyses demonstrating that the reduction in MACE more than compensates for increased AF risk, supporting an overall favorable benefit-risk balance for high-dose omega-3 therapy129.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [129] Bernasconi AA, Maki KC, Finkelstein EA. Cost-effectiveness of long-chain omega-3 supplementation for the secondary prevention of cardiovascular disease in the United States. Value Health. 2025; 28(10): 1481– 1487. doi: 10.1016/j.jval.2025.07.005. 40701340 source
42 of 42

  • The paper relies on this without support.

    The trials in the HR-LD, LR-HD, and LR-LD strata had sufficient statistical power to detect a clinically meaningful increase in AF risk.

    “None of the other three groups showed statistically significant levels of AF risk (ORs 1.07 [high risk, low dose], 1.06 [low risk, low dose] and 1.03 [low risk, high dose]).”
    “This finding, however, was based on relatively few events, therefore should be considered tentative.”

  • The paper relies on this without support.

    High-risk AF patients frequently have underlying structural heart disease.

    “These patients frequently have underlying structural heart disease and are commonly treated with medications such as beta blockers, which may further increase vagal tone through sympathetic inhibition.”

  • The paper relies on this without support.

    High-risk AF patients are commonly treated with beta blockers, which may further increase vagal tone through sympathetic inhibition.

    “These patients frequently have underlying structural heart disease and are commonly treated with medications such as beta blockers, which may further increase vagal tone through sympathetic inhibition.”
3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • The high-dose group is given two different lower bounds

    Minor

    The methods assign 1500 mg/day to the low-dose group, but the results describe the high-dose group as including doses of 1500 mg/day.

  • The pooled OR is attributed to the study-selection figure

    Minor

    The discussion cites Figure 1 for a pooled OR, whereas the paper describes Figure 1 as showing study selection and identifies Figure 2 as the source of the pooled ORs.

  • Baseline AF exclusion is stated both categorically and conditionally

    Minor

    The eligibility criteria say all individuals with known baseline AF were excluded, but the next sentence qualifies that exclusion as occurring only where possible.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 6

  1. International Society for the Study of Fatty Acids and Lipids. ISSFAL policy statement 3: recommendations for intake of polyunsaturated fatty acids in healthy adults. 2004. Accessed May 18, 2026.
  2. Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (ANSES). Avis de l’Agence française de sécurité sanitaire des aliments relatif à l’actualisation des apports nutritionnels conseillés pour les acides gras. 2006. https://www.anses.fr/fr/system/files/NUT2006sa0359.pdf
  3. International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH). Medical Dictionary for Regulatory Activities (MedDRA), version 20.1. McLean (VA): ICH; 2017. Accessed May 18, 2026. https://www.meddra.org
  4. SNOMED International. SNOMED CT: systematized nomenclature of medicine clinical terms. SNOMED International. Accessed May 18, 2026. https://www.snomed.org/get-snomed
  5. Delpech JC. Investigating the impact of an n-3 PUFA combined with vitamin A supplementation on cognition and plasma EV signature in aged individuals [conference abstract]. Presented at: International Society for the Study of Fatty Acids and Lipids (ISSFAL) Congress; 2025
  6. FDA. GRAS notices for menhaden oil. Federal Register. 1997.

Cited by

Sorted by citations

Authors
Abuknesha, N. R., O’Keefe, J. H., Qian, F., Tintle, N. L., Lin, Y., Sun, Y., Qian, H.-Z., Aisen, P. S., Albert, C. M., Aronson, W. J., Asbeutah, A. A. A., Bischoff-Ferrari, H. A., Budoff, M. J., Burns, N. R., Cardenas, C. A., Carlsson, C. M., Chew, E. Y., Cohen, N. J., Fezeu, L. K., Liddell, A., Galan, P., Hull, M. A., Lan, T.-H., Lin, P.-Y., Mengelberg, A., Minihane, A.-M., Quinn, J. F., Sanders, T. A. B., Scholey, A., Schoenfeld, D. A., Sprange, K., Su, K.-P., van Dyck, C. H., Van Hulle, C. A., Vauzour, D., Weber, C., Welty, F. K., Wittert, G., & Harris, W. S.
Affiliations
  • Fatty Acid Research Institute
  • Boston University (US)
  • Sichuan University (CN)
  • GlaxoSmithKline (United States) (US)
  • University of Southern California (US)
  • Cedars-Sinai Medical Center (US)
  • University of California, Los Angeles (US)
  • Beth Israel Deaconess Medical Center (US)
  • University of Basel (CH)
  • The University of Adelaide (AU)
  • University of Wisconsin–Madison (US)
  • National Institutes of Health (US)
  • University of Illinois Urbana-Champaign (US)
  • Inserm (FR)
  • University of Leeds (GB)
  • National Yang Ming Chiao Tung University (TW)
  • China Medical University (TW)
  • Massey University (NZ)
  • University of East Anglia (GB)
  • Oregon Health & Science University (US)
  • King's College London (GB)
  • Northumbria University (GB)
  • Massachusetts General Hospital (US)
  • University of Nottingham (GB)
  • Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine &amp; Public Health (C.A.C., C.M.C., C.A.V.H.).
  • Royal Adelaide Hospital (AU)
  • University of South Dakota (US)
ORCID
Venue
Circulation: Arrhythmia and Electrophysiology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2026-08
Volume
19
Issue
8
Pages
e014785-e014785
ISSN
  • 1941-3084 (ISSN-L)
  • 1941-3149
DOI
10.1161/circep.125.014785
PMC
PMC13489779
OpenAlex
W7171512397
Semantic Scholar
8837387b008d7a27fbdc7bca4200160d668fed21
Cited by
1
References
74
Citations by year
2026: 1
FWCI
2.52
Type
journal article
Language
en
Open access
Licence
Locations
  • Circulation Arrhythmia and Electrophysiology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • UEA Digital Repository (University of East Anglia) (submittedVersion)
  • PubMed Central (submittedVersion, cc-by-nc-nd)
Funders
  • National Heart, Lung, and Blood Institute (T32HL125232)
  • National Eye Institute (ZIAEY000485)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
omega-3 fatty acids, docosahexaenoic acid, eicosapentaenoic acid, atrial fibrillation, new-onset atrial fibrillation, cardiovascular risk, dose-response relationship
MeSH terms
Atrial Fibrillation, Docosahexaenoic Acids, Humans, Middle Aged, Risk Factors, Eicosapentaenoic Acid, Fatty Acids, Omega-3, Incidence, Randomized Controlled Trials as Topic, Treatment Outcome, Risk Assessment

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-19.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-19.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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